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Nonadherence in hypertension : how to develop and implement chemical adherence testing
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Lane, Dan, Lawson, Alexander, Burns, Angela, Azizi, Michel, Burnier, Michel, Jones, Donald J. L., Kably, Benjamin, Khunti, Kamlesh, Kreutz, Reinhold, Patel, Prashanth, Persu, Alexandre, Spiering, Wilko, Toennes, Stefan W., Tomaszewski, Maciej, Williams, Bryan, Gupta, Pankaj and Dasgupta, Indranil (2022) Nonadherence in hypertension : how to develop and implement chemical adherence testing. Hypertension, 79 (1). pp. 12-23. doi:10.1161/hypertensionaha.121.17596 ISSN 0194-911X.
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WRAP-nonadherence-hypertension-how-develop-implement-chemical-adherence-testing-Dasgupta-2022.pdf - Published Version - Requires a PDF viewer. Available under License Creative Commons: Attribution-Noncommercial 4.0. Download (398Kb) | Preview |
Official URL: https://doi.org/10.1161/hypertensionaha.121.17596
Abstract
Nonadherence to antihypertensive medication is common, especially in those with apparent treatment-resistant hypertension (true treatment-resistant hypertension requires exclusion of nonadherence), and its routine detection is supported by clinical guidelines. Chemical adherence testing is a reliable and valid method to detect adherence, yet methods are unstandardized and are not ubiquitous. This article describes the principles of chemical adherence testing for hypertensive patients and provides a set of recommendations for centers wishing to develop the test. We recommend testing should be done in either of two instances: (1) in those who have resistant hypertension or (2) in those on 2 antihypertensives who have a less than 10 mm Hg drop in systolic blood pressure on addition of the second antihypertensive medication. Furthermore, we recommend that verbal consent is secured before undertaking the test, and the results should be discussed with the patient. Based on medications prescribed in United Kingdom, European Union, and United States, we list top 20 to 24 drugs that cover >95% of hypertension prescriptions which may be included in the testing panel. Information required to identify these medications on mass spectrometry platforms is likewise provided. We discuss issues related to ethics, sample collection, transport, stability, urine versus blood samples, qualitative versus quantitative testing, pharmacokinetics, instrumentation, validation, quality assurance, and gaps in knowledge. We consider how to best present, interpret, and discuss chemical adherence test results with the patient. In summary, this guidance should help clinicians and their laboratories in the development of chemical adherence testing of prescribed antihypertensive drugs.
Item Type: | Journal Article | |||||||||
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Subjects: | Q Science > QD Chemistry R Medicine > R Medicine (General) R Medicine > RC Internal medicine R Medicine > RM Therapeutics. Pharmacology T Technology > TP Chemical technology |
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Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School | |||||||||
SWORD Depositor: | Library Publications Router | |||||||||
Library of Congress Subject Headings (LCSH): | Hypertension , Hypertension -- Treatment, Hypotensive agents , Chemical detectors, Mass spectrometry , Patient compliance | |||||||||
Journal or Publication Title: | Hypertension | |||||||||
Publisher: | American Heart Association | |||||||||
ISSN: | 0194-911X | |||||||||
Official Date: | January 2022 | |||||||||
Dates: |
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Volume: | 79 | |||||||||
Number: | 1 | |||||||||
Page Range: | pp. 12-23 | |||||||||
DOI: | 10.1161/hypertensionaha.121.17596 | |||||||||
Status: | Peer Reviewed | |||||||||
Publication Status: | Published | |||||||||
Access rights to Published version: | Open Access (Creative Commons) | |||||||||
Date of first compliant deposit: | 20 January 2022 | |||||||||
Date of first compliant Open Access: | 21 January 2022 | |||||||||
RIOXX Funder/Project Grant: |
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